| Calamity Rose Ranch Llc | |
|
1612 Taylor Ave Muscatine IA 52761-9789 | |
| (563) 261-4434 | |
| Not Available |
| Full Name | Calamity Rose Ranch Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1612 Taylor Ave, Muscatine, Iowa |
| Authorized Official Name and Position | Kayla Carlsten (MANAGER) |
| Authorized Official Contact | 5632614434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Calamity Rose Ranch Llc 1612 Taylor Ave Muscatine IA 52761-9789 Ph: () - | Calamity Rose Ranch Llc 1612 Taylor Ave Muscatine IA 52761-9789 Ph: (563) 261-4434 |
| NPI Number | 1033790845 |
|---|---|
| Provider Enumeration Date | 04/14/2021 |
| Last Update Date | 01/06/2022 |
| Medicare PECOS PAC ID | 3375935315 |
|---|---|
| Medicare Enrollment ID | O20220124002808 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033790845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Kayla Lea Carlsten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770169104 PECOS PAC ID: 5193117133 Enrollment ID: I20220124002829 |
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